Rheumatology Advance Access originally published online on May 29, 2009
Rheumatology 2009 48(8):920-925; doi:10.1093/rheumatology/kep138
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Anti-hnRNP and other autoantibodies in systemic sclerosis with joint involvement
1Department of Biomedicine, Division of Rheumatology AOUC, Denothe Center, University of Florence, Florence, Italy, 2Department of Internal Medicine III, Division of Rheumatology, 3Institute of Medical Biochemistry, University of Vienna, Vienna, Austria, 4Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy and 5Second Department of Medicine, Lainz Hospital, Vienna, Austria.
Correspondence to: Marco Matucci-Cerinic, Division of Rheumatology, Department of Biomedicine, University of Florence, Villa Monna Tessa, Viale Pieraccini, 18 - 5139 Florence, Italy. E-mail: cerinic{at}unifi.it
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Abstract |
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Objectives. To investigate joint involvement in SSc and its relationship with autoantibody to the hnRNP and to anti-cyclic citrullinated peptide (anti-CCP).
Methods. Sera from 55 SSc patients were investigated. Joint involvement was determined by clinical, radiological and ultrasonographical evaluation. Anti-hnRNP proteins A1 and A2 (anti-hnRNP-A1/A2) antibodies were determined by immunoblotting. Anti-CCP, ACA, anti-topo I (ATA), Sm, U1-RNP, ribosomal RNP, Ro/SSA, La/SSB autoantibody and RF were determined.
Results. Six patients were positive for anti-hnRNP-A2 autoantibody and two were anti-A1 positive. Eight patients had joint erosions: seven of the eight patients positive for anti-hnRNP-A2 or A1 presented articular involvement (P < 0.04) and five of the eight erosive patients were positive for either of the two autoantibodies (P < 0.02). Of the four patients positive for anti-CCP, none had anti-hnRNP but three had erosive aspects. ATAs were found in 10 patients, six of which were also positive for anti-hnRNP (P < 0.05). RF was positive in 16 patients and in seven among those with articular involvement (P < 0.04). RF was significantly associated with anti-hnRNP in patients with erosive arthritis (P < 0.02), but not with the presence of anti-hnRNP alone. Epitope mapping of the three strongest anti-hnRNP-A2-positive sera recognized the same major epitope as patients with RA. SSc patients have higher incidence of erosions and anti-hnRNP-A2/A1 positivity. RF test and anti-hnRNP had a statistically significant diagnostic value for articular involvement.
Conclusions. These parameters might suggest that autoantibody to both hnRNP antigens might become a non-specific but useful marker for joint involvement in SSc patients and identify SSc patients prone to develop joint damage.
KEY WORDS: Systemic sclerosis, Anti-hnRNP-A2 antibodies, Articular involvement
*Sergio Generini and Günter Steiner equally contributed to this work.
Submitted 24 May 2008;
revised version accepted 23 April 2009.
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